Chirwere cheshuga insipidus

Chirwere cheshuga insipidus (DI) chinhu chisina kujairika umo itsvo dzisingakwanise kudzivirira kubuda kwemvura.

DI haina kufanana nechirwere cheshuga mellitus mhando 1 uye 2. Zvisinei, isina kurapwa, zvese DI uye chirwere cheshuga chinokonzeresa nyota uye kugara uchiita weti. Vanhu vane chirwere cheshuga vane shuga yakakura muropa (glucose) nekuti muviri haugone kushandisa shuga yeropa simba. Vaya vane DI vane huwandu hweshuga yeropa, asi itsvo hadzikwanise kuenzanisa fluid mumuviri.

Pakati pezuva, itsvo dzako dzinosefa ropa rako rese kakawanda. Kazhinji, yakawanda yemvura inodzoreredzwa, uye chete hushoma weti yakasunganidzwa inoburitswa. DI inoitika apo itsvo dzisingakwanise kuisa weti zvakajairika, uye huwandu hwakawanda hwenyowani inodururwa.

Huwandu hwemvura yakaburitswa mumuti weti inodzorwa neantidiuretic hormone (ADH). ADH inonziwo vasopressin. ADH inogadzirwa mune chimwe chikamu cheuropi chinonzi hypothalamus. Iyo inobva yachengetwa uye kusunungurwa kubva kune iyo pituitary gland. Ichi chiduku chidiki pazasi pezasi pehuropi.

DI inokonzerwa nekushaikwa kweADH inonzi yepakati chirwere cheshuga insipidus. Kana DI ichikonzerwa nekutadza kweitsvo kupindura ADH, mamiriro acho anonzi nephrogenic chirwere cheshuga insipidus. Nephrogenic zvinoreva zvine hukama neitsvo.

Central DI inogona kukonzerwa nekukuvara kune iyo hypothalamus kana pituitary gland semhedzisiro ye:

• Zvinetso zvemajini
• Kukuvara kwemusoro
• Utachiona
• Dambudziko nema ADH-anogadzira maseru nekuda kwechirwere chega auto
  
• Kurasikirwa kweropa kune iyo pituitary gland
• Kuvhiya munzvimbo yepituitary gland kana hypothalamus
• Tumota mukati kana padyo nepituitary gland

Nephrogenic DI inosanganisira kuremara muitsvo. Nekuda kweizvozvo, itsvo hadzipindure neADH. Kufanana nepakati peDI, nephrogenic DI isingawanzoitika. Nephrogenic DI inogona kukonzerwa ne:

• Mimwe mishonga, yakadai se lithiamu
• Zvinetso zvemajini
• Yakakwira mwero wecalcium mumuviri (hypercalcemia)
• Hosha yeitsvo, senge polycystic chirwere cheitsvo

Zviratidzo zveDI zvinosanganisira:

• Nyota yakawandisa inogona kunge yakanyanyisa kana isingadzorwe, kazhinji iine kudiwa kwekunwa yakawanda mvura kana kuda mvura yechando.
• Wakawanda weti vhoriyamu
• Kuwedzeredza kuita weti, kazhinji kunoda kuita weti nguva yega yega masikati neusiku
• Yakasununguka kwazvo, weti yakajeka

Anopa hutano anozobvunza nezve yako nhoroondo yezvokurapa uye zviratidzo.

Miedzo inogona kurairwa inosanganisira:

• Ropa sodium uye osmolality
• Desmopressin (DDAVP) dambudziko
• MRI yemusoro
• Kuongorora urinal
• Weti yekumanikidza uye osmolality
• Weti kuburitsa

Wako mupi anogona kunge iwe ukaona chiremba anonyanya kugadzirisa chirwere chepituitary kuti abatsire kuongorora DI.

Chikonzero chemamiriro ezvinhu ari pasi chichagadziriswa pazvinogoneka.

Central DI inogona kudzorwa nevasopressin (desmopressin, DDAVP). Iwe unotora vasopressin sejekiseni, yemhino pfapfaidzo, kana mapiritsi.

Kana nephrogenic DI ichikonzerwa nemushonga, kumisa iwo mushonga kunogona kubatsira kudzorera zvakajairika itsvo kushanda. Asi mushure memakore mazhinji ekushandiswa kwemimwe mishonga, senge lithiamu, nephrogenic DI inogona kuve yechigarire.

Hereditary nephrogenic DI uye lithiamu-inokonzerwa nephrogenic DI inorapwa nekumwa zvinwiwa zvakakwana kuti zvienderane neweti yakabuda. Mishonga inoderedza weti kubuda inodawo kutorwa.

Nephrogenic DI inorapwa nemishonga inorwisa-kupisa uye diuretics (mapiritsi emvura).

Mhedzisiro inoenderana nechakakonzera kusagadzikana. Kana ikarapwa, DI haikonzeri matambudziko akakomba kana kukonzera kufa kwekutanga.

Kana nyota yemuviri wako iri yakajairika uye uchikwanisa kunwa zvinwiwa zvakakwana, hapana chakakosha mitezo yemuviri wemvura kana muyero wemunyu.

Kusanwa zvinwiwa zvakakwana kunogona kutungamira mukushaya mvura uye kusaenzana kwemagetsi, izvo zvinogona kuva nenjodzi huru.

Kana DI ikarapwa nevasopressin uye yako yenyota yekudzora muviri haina kujairika, kunwa zvinwiwa zvakawanda kupfuura izvo zvinoda muviri wako zvinogona kukonzeresa kusaenzana kwe electrolyte ine njodzi.

Fonera mupiki wako kana iwe ukaita zviratidzo zveDI.

Kana iwe uine DI, bata wako mupi kana kazhinji weti kana yakanyanyisa nyota ichidzoka.

• Endocrine masero
• Osmolality bvunzo

Hannon MJ, Thompson CJ. Vasopressin, chirwere cheshuga insipidus, uye chirwere cheasina kukodzera antidiuresis. Muna: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Vakuru uye Chiremba. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016: chits.

Verbalis JG. Kukanganiswa kwemvura yakaringana. Mune: Skorecki K, Chertow GM, Marsden PA, Taal MW, Yu ASL, eds. Brenner uye Rector Iyo Itsvo. 10th ed. Philadelphia, PA: Elsevier; 2016: chits.